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Babigumira R, Veierød MB, Hosgood HD, Samuelsen SO, Bråtveit M, Kirkeleit J, Rothman N, Lan Q, Silverman DT, Friesen MC, Shala NK, Grimsrud TK, Stenehjem JS. Benzene exposure and risk of lung cancer in the Norwegian Offshore Petroleum Worker cohort: a prospective case-cohort study. Occup Environ Med 2023:oemed-2023-109139. [PMID: 38154914 DOI: 10.1136/oemed-2023-109139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE The objective of our study was to examine whether occupational exposure to benzene is associated with lung cancer among males in the Norwegian Offshore Petroleum Workers cohort. METHODS Among 25 347 male offshore workers employed during 1965-1998, we conducted a case-cohort study with 399 lung cancer cases diagnosed between 1999 and 2021, and 2035 non-cases sampled randomly by 5-year birth cohorts. Individual work histories were coupled to study-specific job-exposure matrices for benzene and other known lung carcinogens. Weighted Cox regression was used to estimate HRs and 95% CIs for the associations between benzene exposure and lung cancer, by major histological subtypes, adjusted for age, smoking and occupational exposure to welding fumes, asbestos and crystalline silica. Missing data were imputed. RESULTS For lung cancer (all subtypes combined), HRs (95% CIs) for the highest quartiles of benzene exposure versus unexposed were 1.15 (0.61 to 2.35) for cumulative exposure, 1.43 (0.76 to 2.69) for duration, and 1.22 (0.68 to 2.18) for average intensity (0.280≤P-trend≤0.741). For 152 adenocarcinoma cases, a positive trend was observed for exposure duration (P-trend=0.044). CONCLUSIONS In this cohort of offshore petroleum workers generally exposed to low average levels of benzene, we did not find an overall clear support for an association with lung cancer (all subtypes combined), although an association was suggested for duration of benzene exposure and adenocarcinoma. The limited evidence might be due to restricted statistical power.
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Affiliation(s)
- Ronnie Babigumira
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
| | - H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Magne Bråtveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jorunn Kirkeleit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health (NIOH), Oslo, Norway
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Qing Lan
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Debra T Silverman
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Nita Kaupang Shala
- Department of Research, Cancer Registry of Norway, Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Tom K Grimsrud
- Department of Research, Cancer Registry of Norway, Oslo, Norway
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Warden H, Richardson H, Richardson L, Siemiatycki J, Ho V. Associations between occupational exposure to benzene, toluene and xylene and risk of lung cancer in Montréal. Occup Environ Med 2018; 75:696-702. [PMID: 29764994 DOI: 10.1136/oemed-2017-104987] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 04/18/2018] [Accepted: 04/28/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Benzene, toluene and xylene (BTX) are aromatic hydrocarbons with inconclusive evidence of lung carcinogenicity. The aim of this research was to assess the associations between occupational exposures to BTX agents and lung cancer. METHODS In a population-based case-control study of lung cancer, occupational histories were obtained and exposures were assessed by experts. Unconditional multivariate logistic regression was used to estimate ORs and 95% CIs, among men, between various metrics of occupational exposure to BTX and lung cancer, while adjusting for established and possible risk factors. RESULTS Considerable overlap was found between occupational exposure to BTX, where the majority of exposed participants were exposed to all three chemicals. Lung cancer was associated with exposure to benzene (OR=1.35; 95% CI 0.99 to 1.84), toluene (OR=1.31; 95% CI 0.99 to 1.74) and xylene (OR=1.44; 95% CI 1.03 to 2.01). While these results were adjusted for smoking and other recognised and possible lung cancer risk factors, they were not mutually adjusted among the three BTX agents. CONCLUSIONS Our study provides suggestive evidence that occupational exposure to one or more of the BTX agents may be associated with lung cancer.
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Affiliation(s)
- Hunter Warden
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Harriet Richardson
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Lesley Richardson
- University of Montréal Hospital Research Centre (CRCHUM), Health Innovation and Evaluation Hub, Montréal, Québec, Canada
| | - Jack Siemiatycki
- University of Montréal Hospital Research Centre (CRCHUM), Health Innovation and Evaluation Hub, Montréal, Québec, Canada.,Department of Social and Preventive Medicine, University of Montréal, Montréal, Québec, Canada
| | - Vikki Ho
- University of Montréal Hospital Research Centre (CRCHUM), Health Innovation and Evaluation Hub, Montréal, Québec, Canada.,Department of Social and Preventive Medicine, University of Montréal, Montréal, Québec, Canada
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Yuan TH, Shen YC, Shie RH, Hung SH, Chen CF, Chan CC. Increased cancers among residents living in the neighborhood of a petrochemical complex: A 12-year retrospective cohort study. Int J Hyg Environ Health 2017; 221:308-314. [PMID: 29287935 DOI: 10.1016/j.ijheh.2017.12.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 12/07/2017] [Accepted: 12/10/2017] [Indexed: 02/06/2023]
Abstract
This study investigates whether cancers are increased for residents living in the vicinity of a petrochemical complex with coal power plants and refineries. We recruited a residential cohort of 2388 long-term residents aged above 35 years in 2009-2012 who lived within a 40 km radius of the complex. We measured their internal exposure biomarkers of urinary carcinogenic metals and retrospectively compared cancer incidences between those who lived fewer than 10 km from the complex (high exposure, HE) and those who lived more than 10 km from the complex (low exposure, LE). Residents had lived in their respective areas for 12 years, since the complex began operating in mid-1999. This included two periods of operation: 0-9 years and 10-12 years. Crude cumulative incident rates (CIRs) of all cancers were calculated for new cancer cases (ICD-9: 140-165, 170-176, 179-208) recorded in the Taiwan Health Insurance Database over total person-years at risk in each study period. Poisson regression was applied to estimate relative risks for the CIRs of all cancers between HE and LE areas during the 10-12 years since the beginning of the complex's operation, adjusting for age, gender, body mass index, smoking, hepatitis C, and occupational exposure. We found that our study subjects in HE areas had higher urinary carcinogenic metal levels, including As, Cd, Hg, Pb, and V, and higher prevalence rates of hepatitis C than those in LE areas. After the complex had been operating for 10-12 years, SIRs per 1000 person-years for all cancers in HE and LE areas were 4.44 vs. 2.48 for all subjects, 15.2 vs. 4.86 for elder subjects aged above 60 years, and 2.94 vs. 2.71 for female subjects. Correspondingly, the adjusted relative risks of CIRs for all cancers between HE and LE areas were 1.29 (95% CI: 0.99-1.68) for all subjects, 1.52 (1.04-2.22) for elder subjects, 1.41 (1.00-1.97) for female subjects, and 1.91 (1.15-3.19) for female elderly subjects. We conclude that elder and female residents living within 10 km of a petrochemical complex had higher carcinogenic exposure and cancers than those living farther away from the complex after the complex had been operating for 10 years.
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Affiliation(s)
- Tzu-Hsuen Yuan
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Cheng Shen
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ruei-Hao Shie
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan; Green Energy and Environment Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Shou-Hung Hung
- Department of Community and Family Medicine, National Taiwan University Hospital Yun-Lin Branch, Douliou City, Taiwan
| | - Chen-Fang Chen
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chang-Chuan Chan
- Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan.
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Ramirez MI, Arevalo AP, Sotomayor S, Bailon-Moscoso N. Contamination by oil crude extraction - Refinement and their effects on human health. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 231:415-425. [PMID: 28826075 DOI: 10.1016/j.envpol.2017.08.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 08/01/2017] [Accepted: 08/02/2017] [Indexed: 06/07/2023]
Abstract
The harmful effects of oil on various species of flora and fauna have been studied extensively; however, few studies have studied the effects of oil exposure on human health. The objective of this research was to collect information on the acute health effects and serious psychological symptoms of the possible consequences of such exposure to crude oil. Some studies focused on the composition of different chemicals used in the extraction process, and wastes generated proved to be highly harmful to human health. Thus, studies have shown that individuals who live near oil fields or wells - or who take part in activities of cleaning oil spills - have presented health conditions, such as irritation to the skin, eyes, mucous membranes, kidney damage, liver, reproductive, among others. In Ecuador, this reality is not different from other countries, and some studies have shown increased diseases related with oil crude and oil spills, like skin irritation, throat, liver, lung, infertility, and abortions, and it has been linked to childhood leukemia. Other studies suggest a direct relationship between DNA damage because of oil resulting in a genetic instability of the main enzymes of cellular metabolism as well as a relationship with some cancers, such as leukemia.
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Affiliation(s)
- Maria Isabel Ramirez
- Departamento de Ciencias de La Salud, Universidad Técnica Particular de Loja, San Cayetano Alto, Loja, 11-01-608, Ecuador.
| | - Ana Paulina Arevalo
- Departamento de Ciencias de La Salud, Universidad Técnica Particular de Loja, San Cayetano Alto, Loja, 11-01-608, Ecuador.
| | - Santiago Sotomayor
- Departamento de Ciencias de La Salud, Universidad Técnica Particular de Loja, San Cayetano Alto, Loja, 11-01-608, Ecuador.
| | - Natalia Bailon-Moscoso
- Departamento de Ciencias de La Salud, Universidad Técnica Particular de Loja, San Cayetano Alto, Loja, 11-01-608, Ecuador.
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Incidence of Myelodysplastic Syndrome in UK Petroleum Distribution and Oil Refinery Workers, 1995-2011. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13050474. [PMID: 27164123 PMCID: PMC4881099 DOI: 10.3390/ijerph13050474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/11/2016] [Accepted: 04/28/2016] [Indexed: 11/17/2022]
Abstract
The incidence of myelodysplastic syndrome (MDS) experienced by cohorts of 16,467 petroleum distribution workers and 28,554 oil refinery workers has been investigated. Study subjects were all those male employees first employed at one of 476 UK petroleum distribution centres or eight UK oil refineries in the period 1946–1974; all subjects had a minimum of twelve months employment with some employment after 1st January, 1951. Observed numbers (Obs) of MDS cases were compared with expectations based on national incidence rates for the period 1995–2011. The overall standardised registration ratio (SRR) was 73 (Obs = 17) in petroleum distribution workers for the age-range 15–84 years, and 77 (Obs = 21) for the age-range 15–99 years. The overall SRR was 81 (Obs = 29) in oil refinery workers for the age-range 15–84 years, and 83 (Obs = 36) for the age-range 15–99 years. More detailed analyses were carried out in terms of year of registration, period from hire, decade of hire, and duration of employment. The overall SRR findings did not provide clear evidence for the presence of an occupational cancer hazard, and provide no support for the hypothesis that low-level benzene exposure has an important effect on the risks of MDS.
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Jiang A, Rambhatla P, Eide M. Socioeconomic and lifestyle factors and melanoma: a systematic review. Br J Dermatol 2015; 172:885-915. [PMID: 25354495 DOI: 10.1111/bjd.13500] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2014] [Indexed: 12/27/2022]
Affiliation(s)
- A.J. Jiang
- Stritch School of Medicine; Loyola University Chicago; Maywood IL U.S.A
| | - P.V. Rambhatla
- Department of Dermatology; Henry Ford Hospital; New Center One; 3031 West Grand Blvd, Suite 800 Detroit MI 48202 U.S.A
| | - M.J. Eide
- Department of Dermatology; Henry Ford Hospital; New Center One; 3031 West Grand Blvd, Suite 800 Detroit MI 48202 U.S.A
- Department of Public Health Sciences; Henry Ford Hospital; New Center One; 3031 West Grand Blvd, Suite 800 Detroit MI 48202 U.S.A
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Salerno C, Berchialla P, Palin LA, Vanhaecht K, Panella M. Cancer morbidity of residents living near an oil refinery plant in North-West Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2012; 23:342-351. [PMID: 23067277 DOI: 10.1080/09603123.2012.733938] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Cerano is a municipality of the Province of Novara (North-West Italy). To assess the morbidity associated to its proximity to a petrochemical plant, standardized incidence ratios (SIRs) of oncological pathologies in the period 2003-2009 were calculated based on age-sex specific rates for the district of the Local Health Authority of Novara (ASL13) and the main regional city of Turin. For all cancers combined, men showed a significant higher risk (SIR: 1.21; 95% CI: 1.02-1.40) compared to the ASL13 population; significantly lower risks for both men and women were observed in comparison to the Turin population. Among women, a significant excess of mesothelioma cancers was reported; a significantly higher risk for lympho-haematopoietic pathologies was also observed compared to the Turin population only. Several other cancers have significantly lower rates in Cerano for both men and women. Despite some studies' limitations, these findings could suggest potential chemical risk factors and need further investigation.
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Affiliation(s)
- Christian Salerno
- Department of Translational Medicine, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
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8
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Sorahan T. Cancer incidence in UK electricity generation and transmission workers, 1973-2008. Occup Med (Lond) 2012; 62:496-505. [DOI: 10.1093/occmed/kqs152] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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9
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Evaluation of exposure biomarkers in offshore workers exposed to low benzene and toluene concentrations. Int Arch Occup Environ Health 2011; 85:261-71. [DOI: 10.1007/s00420-011-0664-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Accepted: 06/01/2011] [Indexed: 10/18/2022]
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10
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Kane EV, Newton R. Occupational exposure to gasoline and the risk of non-Hodgkin lymphoma: a review and meta-analysis of the literature. Cancer Epidemiol 2010; 34:516-22. [PMID: 20561834 DOI: 10.1016/j.canep.2010.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2009] [Revised: 05/24/2010] [Accepted: 05/25/2010] [Indexed: 12/31/2022]
Abstract
AIMS Gasoline comprises over 500 chemicals, including the known or suspected carcinogens benzene, 1,3-butadiene, ethylbenzene and methyl tert-butyl ether (MTBE). To assess whether work in the production, distribution and use of gasoline is associated with non-Hodgkin lymphoma (NHL), we reviewed the published literature on this topic. METHOD English-language peer-reviewed articles were identified by keyword searches of bibliographic databases. Twenty-two cohorts and thirteen case-control studies examined the risk of NHL among persons employed in the downstream petroleum industry. RESULT No positive associations were found with the exception of one study. The pooled risk estimate from a random-effects meta-analysis was 1.02 (95% confidence interval (CI) 0.94-1.12). Although there were no estimates available, exposure is likely to have varied by occupation, location and time period; there was no evidence however that risk estimates varied by any of these factors. NHL is a heterogeneous disease, yet no data were reported for NHL subtypes. CONCLUSION In summary, there is no suggestion across an extensive literature that exposure to gasoline at the levels workers' experience in an occupational setting increases the risk of NHL.
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Affiliation(s)
- Eleanor V Kane
- Epidemiology and Genetics Unit, Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK.
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11
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Steinmaus C, Smith AH, Jones RM, Smith MT. Meta-analysis of benzene exposure and non-Hodgkin lymphoma: biases could mask an important association. Occup Environ Med 2008; 65:371-8. [PMID: 18417556 PMCID: PMC4353490 DOI: 10.1136/oem.2007.036913] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Benzene is a widely recognised cause of leukaemia but its association with non-Hodgkin's lymphoma (NHL) is less well established. The goal of this project is to review the current published literature on this association. METHODS We performed a meta-analysis of cohort and case-control studies of benzene exposure and NHL and a meta-analysis of NHL and refinery work, a potential source of benzene exposure. RESULTS In 22 studies of benzene exposure, the summary relative risk for NHL was 1.22 (95% CI 1.02 to 1.47; one-sided p value = 0.01). When studies that likely included unexposed subjects in the "exposed" group were excluded, the summary relative risk increased to 1.49 (95% CI 1.12 to 1.97, n = 13), and when studies based solely on self-reported work history were excluded, the relative risk rose to 2.12 (95% CI 1.11 to 4.02, n = 6). In refinery workers, the summary relative risk for NHL in all 21 studies was 1.21 (95% CI 1.00 to 1.46; p = 0.02). When adjusted for the healthy worker effect, this relative risk estimate increased to 1.42 (95% CI 1.19 to 1.69). CONCLUSIONS The finding of elevated relative risks in studies of both benzene exposure and refinery work provides further evidence that benzene exposure causes NHL. In addition, the finding of increased relative risks after removing studies that included unexposed or lesser exposed workers in "exposed" cohorts, and increased relative risk estimates after adjusting for the healthy worker effect, suggest that effects of benzene on NHL might be missed in occupational studies if these biases are not accounted for.
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Affiliation(s)
- C Steinmaus
- School of Public Health, University of California, Berkeley, California, USA.
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13
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Abstract
Benzene-induced acute myeloid leukemia (AML) is considered a secondary form of AML, based both in theory and on limited cohort observations. Its latency, cytogenetic aberrations, and clinical features are thought similar to, or identical with, AML resulting from the use of modern day cytotoxic agents for chemotherapy and immunotherapy. Although distinction between secondary AML and the far more common de novo AML is difficult to establish with certainty in any given case, latency from toxic therapeutic and environmental exposure and certain clinical and pathological features generally separate these two entities. AML is the only human neoplasm proven to be potentially caused by benzene, which actually is an obsolete form of chemotherapy. Despite many years of environmental regulation, alleged toxic exposure to this ubiquitous chemical has become an expanding area of litigation. A review of benzene-induced AML suggests that, in developed countries, this entity should no longer merit serious consideration among workers in the modern petrochemical industry and related fields.
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MESH Headings
- Acute Disease
- Attitude of Health Personnel
- Benzene/adverse effects
- Benzene/therapeutic use
- Chromosome Aberrations/chemically induced
- Chromosome Inversion
- Chromosomes, Human, Pair 15
- Chromosomes, Human, Pair 16
- Chromosomes, Human, Pair 17
- Chromosomes, Human, Pair 21
- Chromosomes, Human, Pair 8
- Developed Countries
- Drug-Related Side Effects and Adverse Reactions
- Humans
- Leukemia, Myeloid/chemically induced
- Leukemia, Myeloid/diagnosis
- Leukemia, Myeloid/epidemiology
- Leukemia, Myeloid/etiology
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/pathology
- Occupational Diseases/chemically induced
- Occupational Diseases/epidemiology
- Occupational Exposure/adverse effects
- Occupational Exposure/analysis
- Petroleum/adverse effects
- Translocation, Genetic
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Affiliation(s)
- Ethan A Natelson
- Department of Medicine, Weill Medical College at the Methodist Hospital, Houston, Texas 77030, USA.
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14
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Tsai SP, Ahmed FS, Wendt JK, Foster DE, Donnelly RP, Strawmyer TR. A 56-year mortality follow-up of Texas petroleum refinery and chemical employees, 1948-2003. J Occup Environ Med 2007; 49:557-67. [PMID: 17495698 DOI: 10.1097/jom.0b013e318057777c] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To further investigate the mortality risk of employees who worked in the petroleum refinery industry, we updated an earlier investigation by extending the mortality follow-up by an additional 14 years through 2003. METHODS The cohort consisted of 10,621 employees with an average follow-up of 34 years. We used the standardized mortality ratio (SMR) adjusted for age, race, and calendar years as a measure of risk. RESULTS Overall mortality (SMR=0.77, 95% confidence interval [CI], 0.74-0.79), all cancer mortality (SMR=0.87, 95% CI=0.82-0.93), and most cause-specific mortalities for the total study population were lower than or similar to that of the population of Harris County, Texas. This study did not show a significant increase in leukemia in the total population or in any of the subgroups. The only statistically significant excess of mortality found in this study was an increase in mesothelioma among maintenance employees; the SMR was 4.78 (95% CI=2.54-8.17) among employees who worked for a minimum of one year and was 7.51 (95% CI=3.75-13.45) among those with 10 or more years of employment and 20 or more years of latency. CONCLUSIONS After more than half a century of follow-up, employees at this facility continue to show more favorable mortality outcomes than the general local population. Overall, no statistically significant increase of leukemia or of any of the specific cell types was found. The increased mesothelioma is likely related to past exposure to asbestos.
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Affiliation(s)
- Shan P Tsai
- Shell Health Services, Shell Oil Company, Houston, TX 77252-2463, USA.
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Chang CK, Astrakianakis G, Thomas DB, Seixas NS, Camp JE, Ray RM, Gao DL, Wernli KJ, Li W, Fitzgibbons ED, Vaughan TL, Checkoway H. Risks of biliary tract cancer and occupational exposures among Shanghai women textile workers: a case-cohort study. Am J Ind Med 2006; 49:690-8. [PMID: 16830349 DOI: 10.1002/ajim.20345] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Biliary tract cancer (BTC) is a relatively rare malignancy worldwide. Little is known about potential etiologic contributions of occupational exposures. METHODS The associations between occupational exposures to textile dusts and chemicals and BTC are investigated in a cohort of 267,400 women textile workers in Shanghai, China. A nested case-cohort analysis of 162 BTC cases diagnosed during 1989-1998 was conducted with a reference subcohort of 3,188 workers. Exposures to workplace dusts and chemicals were reconstructed by linking complete work history data with a job-exposure matrix (JEM). Hazard ratios (HR) and dose-response trends were estimated by Cox proportional hazards modeling modified for case-cohort design. RESULTS An elevated risk of > or = 1-year employment in maintenance jobs (HR 2.92, 95% CI: 1.48, 5.73) with a significant trend by duration is observed. Excess risk was also found for > or = 20 years exposure to metals (HR 2.50, 95% CI: 1.09, 5.72). CONCLUSIONS Long-term exposure to maintenance work and metals in the textile industry may have increased BTC risk in this population.
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Affiliation(s)
- Chin-Kuo Chang
- Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA.
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